[Interest of positioning control in onboard imaging and its delegation to the therapists]

The delegation of the on board imaging position control, from the radiation oncologist to the therapist, is justified by the generalization of the image-guided radiotherapy techniques which are particularly time consuming. This delegation is however partial. Indeed, the validation of the position by the therapist can be clearly performed when the registration is based on bony landmark or fiducial. The radiation oncologist needs however to make the validation in case of large target displacement, in more complex soft tissue-based registration, and in case of stereotactic body radiation therapy. Moreover, this delegation implies at least three conditions which are first the training of the staff, then the formalization of the procedures, responsibilities and delegations and finally, the evaluation of the practices of IGRT.